Venous malformation with localized intravascular coagulopathy in children treated with sclerotherapy and LWMH

To define clinical characteristics and optimal management of localized intravascular coagulopathy (LIC) in pediatric venous malformations (VMs).

Study Design: Retrospective cohort study of 116 pediatric VM patients who underwent sclerotherapy.
LIC Definition: LIC was defined as D-dimer ≥0.60 μg/ml.
Statistical Analysis: Chi-square test, Fisher's exact test, Mann-Whitney U test, and correlation analysis were used.

51 patients had LIC (38 mild, 11 moderate, 2 severe).
No significant association between LIC and sex, age, or anatomic location.
Severe LIC cases were linked to extensive VMs involving ≥2 joint planes.
Sclerotherapy combined with low-molecular-weight heparin (LMWH) corrected coagulation abnormalities in severe LIC.

LIC occurrence is independent of demographic or anatomic factors, while severity correlates with lesion burden.

Routine screening for occult VM in unexplained pediatric coagulopathy is supported.